Pre- and Post-Egg Retrieval - What Worked for Us

I've been thinking about writing about the lifestyle/diet changes we made pre- and post-egg retrieval as well as pre- and post-transfer. There are some things I wish I had known about before we got started (like cutting out alcohol and caffeine several months beforehand), so I thought it might be helpful to share these with anybody who is getting ready for an egg retrieval!

Now that I have 2 egg retrievals under my belt, I thought I'd share what worked for us. I will preface this by saying that I am not a doctor, and that not everything I am sharing was specifically recommended by my doctor. A lot of what I ended up doing came recommended by other people going through IVF, research studies/articles, other fertility clinics, etc. I will try to link to resources where I can. Please don't feel like you have to do any of these things, or that you messed things up by not doing these things. My thought process is this: Since we are investing so much into this--financially, emotionally, physically--I want to do whatever I can (reasonably) do to improve things, whether that is egg/sperm quality, number of eggs retrieved, quality of embryos, implantation rate, etc. I figure, even if there isn't scientific proof behind things, if it's not going to hurt, why not give it a shot so that I don't regret things later? I'd rather know I tried my best than live with the "what if?" later on. 

Scroll down to the bottom for Conclusions, or a recap of what I discuss in this post.

Exercise: 3 Months and Prior
This is absolutely something you should talk to your doctor about. They will let you know if you're at a healthy BMI, and what you can do to help achieve one. Doctors generally recommend achieving a normal BMI, as "obesity has been found to alter mitochondrial function and increase oxidative stress, leading to reduced fertility and egg quality. It can also alter hormonal balance, disrupting ovulation." If you have some time before starting Stims--maybe you're saving up money, or waiting for a good time--this is a great time to start exercising and improving your overall health.

Exercise: During/After Stims
You should definitely consult your doctor about exercise during/after Stims, and during/after the 2WW. My nurse said I could continue my normal cardio/strength training during the early stages of injections (days 1-5), but by day 6, I would want to decrease intensity and focus on non-impact exercises (yoga, light elliptical, swimming, etc.). The main concern with strenuous exercise during Stims is that the medications will cause your ovaries to enlarge as the follicles start growing. According to the Southern California Reproductive Center, "You need to protect your ovaries during this sensitive time and avoid strenuous training. Your IVF cycle is not a time to push any limitations...Your body is already working extremely hard during your IVF cycle, so take the time to acknowledge yourself for that." One thing to think about after egg retrieval is the risks of ovarian torsion or ovarian hyperstimulation syndrome (OHSS), so following your doctor's orders and avoiding strenuous exercise are very important here.

Diet: 3 Months and Prior
Alcohol/Caffeine
I read an article that said that "given that egg and sperm maturation takes up to 3 months, it is ideal to stop/reduce alcohol consumption for at least three months before attempting pregnancy." I didn't know this prior to my first egg retrieval, so I had a minor freak out and wrote all about it here. I came to the conclusion that it wouldn't hurt to reduce/eliminate alcohol/caffeine in the 3 months prior to IVF (for both you and your partner), but that ultimately, it is not going to drastically compromise your chances. Knowing this information, we eliminated caffeine/alcohol from our diets 3 months before our 2nd egg retrieval, and I think it did make some improvements for us!

Vitamins/Supplements
My nurse did encourage me to take a prenatal vitamin before we started Stims. Memphis fertility specialist, Dr. Amelia Bailey, recommends that "a woman planning pregnancy should start taking a prenatal vitamin with DHA 6 months before conceiving." She (and other other specialists) also recommend Coenzyme Q10 (CoQ10), DHEA, DHA, folic acid (as needed), and Vitamin D (as needed). CoQ10 is helpful for overall sperm and egg health. Vitamin D insufficiency and deficiency in women attempting to get pregnant has also become an increasing concern. (This article is really helpful if you're thinking of taking any of these mentioned vitamins/supplements.) I personally just took a prenatal vitamin, fish oil, and Vitamin D supplements before and during Stims.

According to Dalene Barton-Schuster, Certified Herbalist and Birth Doula, "The life cycle of sperm, from production to maturation for ejaculation, ranges from 42 to 76 days...to make a plan for increasing fertility and boosting sperm health, you should start at least 2-3 months prior to giving sperm for IVF." CoQ10 is said to improve men's sperm motility and count. There are also many articles claiming that selenium, Vitamin C, zinc, and other vitamins/supplements can help improve male reproductive health. Three months prior to our 2nd egg retrieval, David cut out caffeine/alcohol. He also took a multivitamin, 200mg of Ubiquinol (CoQ10), and the Daily Wellness Company's Fertility Blend for Men daily. The Fertility Blend for Men is something I stumbled upon a few weeks prior to our first egg retrieval. It has great reviews online, and contains many of the recommended supplements to boost male fertility, such as L-carnitine, Vitamins B/C/E, zinc, and selenium.

Here's a helpful article on pre-conception vitamins written by Sarah Yang for the Bump. Here is an article on nutritional guidelines for your fertility treatment published on the Southern California Reproductive Center's blog.

Diet: During/After Stims
My nurse told me that during Stims, "the recommendation for caffeine intake is less than 600 mg" per day and that restricting "all caffeine intake is preferred." She also said that "no alcohol intake is preferred/recommended." I checked and she said that it would be okay to drink caffeine-free Diet Coke and decaf coffee. I had eliminated diet sodas and artificial sugar from my diet once I became pregnant, so it was easy for me to continue avoiding it during my 2nd egg retrieval, though I've added in the occasional Diet Coke or Splenda now that I'm done breastfeeding. (We don't plan to do our next embryo transfer for awhile.)

I think that eating healthy is something that is great to do now for yourself and for your future baby! There are a lot of diet changes you need to make when you become pregnant, so it doesn't hurt to start getting used to those changes now.

Acupuncture
I had never given much thought to holistic medicine (except for chiropractic) prior to IVF, but my fertility clinic actually has an acupuncture facility right in their building, so it was something I looked into. Some studies have shown that "when used in conduction with Western fertility treatments, acupuncture increases conception rates by 26%." Others say that "acupuncture is not harmful and most of those so treated swear by it. For the nay-sayers, what can be said with certainty is that at the very least acupuncture has a 'feel good' aspect to it and in most, evokes a psychological benefit that should not be discounted." My thoughts are that it's not going to hurt anything, so why not give it a shot? I didn't do acupuncture prior to my first egg retrieval, but I did do it for about a month prior to my 2nd one, and I think it did make some improvements for us the second time around.

Conclusions
My main suggestions for Before Stims (preferably 3 months or prior):

• Exercise and get to a healthy BMI
• Eat healthy--limit/eliminate caffeine/alcohol, fake sugars, trans fats, processed foods, etc.
• Take prenatal/multivitamins, CoQ10, and other recommended vitamins/supplements
• Acupuncture (talk to your acupuncturist, but you can start 3 months prior, or even 3-4 weeks prior to Stims)

My main suggestions for During/After Stims:

• Limited non-strenuous exercise (as discussed with your doctor!)
• Continue to eat healthy--eliminate caffeine/alcohol, fake sugars, trans fats, processed foods, etc.
• Continue taking prenatal/multivitamins, and other recommended vitamins/supplements as needed (and recommended by your doctor)
• Acupuncture (talk to your acupuncturist about what they recommend for during Stims and leading up to the embryo transfer...)

Bloating, Weight Gain, and Ultrasounds

Progression of abdominal swelling:
Left - Stims: Day 6; Center - Stims: Day 10; Right - Morning of ER

I read that ovaries are normally the size of walnuts, but with IVF can swell up to the size of plums or even small grapefruits! So prior to starting stims, I was preparing myself for the swelling and possible weight gain. (I've read varying accounts on weight gain--some women gained nothing, some gained only 5 lb., others gained closer to 15+ lb.) Today, (the morning of my ER, which I will write about in the next post), I weighed myself and I was up 1.8 lb. I will say that I had a lot less swelling than I was expecting, and my discomfort was pretty manageable (with only a few days of bad headaches at the beginning and a little bit of abdominal "heaviness" towards days 8-10 of stims). I thought I'd post a comparison of my abdomen: Day 6 vs. Day 10 vs. Day 12/ER. I actually looked and felt more bloated on some of the days in the middle of stimming compared to the morning of my ER.

Top: Uterine lining; Bottom: Follicles in my ovary

I also wanted to share some photos from my ultrasound on Day 10 (5.29.16). This entire process has been so interesting and I've learned a lot about my body and what it's capable of doing. 

I've also really surprised myself at how strong I am when I need to be. This first cycle (up to ER) was scary and difficult at times, but it was nothing I couldn't handle and make it through. I've endured endless blood draws and needle pricks, had a ton of invasive ultrasounds; I've gotten over any kind of embarrassment with doctors; I've learned to give myself subcutaneous injections! I've also spent time getting myself healthy--both mentally and physically. I'm surprised that eliminating alcohol and caffeine was as easy as it has been (though I have definitely craved a glass of Malbec here and there!). 

If you are reading this and you are interested in IVF, but are scared of the needles, doctors, and protocol involved--be brave! If I can do this, so can you. In the end, those needle pricks, blood draws, and doctors appointments will (hopefully) be totally worth it. I'm keeping my eye on the prize!

Pulling the Trigger Tonight!

Today is Memorial Day, day 11 of stims, and I went in for an early u/s and bw appointment and was told I'd be triggering this evening! Last night I decreased my Gonal-f from 125 IU to 100 IU and kept the Menopur the same; Cetrotide was the same this morning, and I will be triggering tonight with 0.8 cc of Lupron (Leuprolide Acetate).

My estrogen (estradiol) levels were 3606 (Saturday, 5/28/16); 4835 (Sunday, 5/29/16); and 5604 (today, 5/30/16). They are seeing approximately 16-18 large follicles. I'm hoping this will be 18-20 by Wednesday, which is Egg Retrieval (ER) day!

My trigger is scheduled for 9:46pm tonight, and the ER will be exactly 36 hours after this, so 9:45am on Wednesday, 6/1/16. Tomorrow night I will take 2 Azithromycin (500 mg) tablets, and then no food or water after midnight. I am excited about the upcoming ER, and not super nervous or scared yet. I'm sure it will start settling in tomorrow night!

Day 8 of Stims

Stims: Day 8 - 4th morning of Cetrotide (25 mg)
7 nights of Gonal-f (175-150 IU) & Menopur (75-150 IU)

Today is my 8th day of injections. The veins in my arms are a little bruised so blood draws are a bit harder for the phlebotomists. During the u/s, the sonographer found 10 follicles in my left ovary and 14 in my right. She said that I could expect to make appointments for every day this weekend. I keep forgetting that the fertility clinic is open 24/7, because the doctors, nurses, sonographers, etc. need to be ready at any point in time to retrieve eggs and implant embryos! Reminds me of when I worked at an emergency vet hospital all during grad. school. Memorial Day is Monday, and they don't get the day off.

I didn't get a call from my nurse this afternoon so I called the after-hours number and the nurse on-call called me back to tell me that the doctor wants me to decrease the Gonal-f dosage from 150 IU to 125 IU, and to keep the Menopur and Cetrotide doses as is. I have another appointment scheduled for tomorrow morning (Saturday).

David comes tomorrow night, so I am excited. It's been lonely and difficult not having him here, and I know he's been bored at home by himself so hopefully this will make things a little easier. David coming means that the egg retrieval is right around the corner! We don't have the date set yet, but it should be some time next week!

Alcohol and Caffeine

My nurse told me that during stims, "the recommendation for caffeine intake is less than 600 mg" per day and that restricting "all caffeine intake is preferred." She also said that "no alcohol intake is preferred/recommended." I checked and she said that it would be okay to drink caffeine-free Diet Coke and decaf coffee. 

I was a little worried the other night because I read online that "research into alcohol consumption among couples being treated at a fertility clinic found fewer successful pregnancies when the women drank several glasses of wine a week, or the man had a daily beer" (The Guardian, 2009). Another article said that "drinking as little as three small glasses of wine a week could reduce a woman's chances of conceiving by two thirds over a 3-year period," and that "given that egg and sperm maturation takes up to 3 months, it is ideal to stop/reduce alcohol consumption for at least three months before attempting pregnancy" (RSCBA, 2013).

This freaked me out. I had been drinking the occasional glass of wine up until the night before stims, and I know David has had the occasional beer as usual. The doctor and nurse never told us to cut out alcohol prior to treatment. I sent my nurse a panicked email, and she responded the next day with "Not to worry. An occasional glass of wine or beers here and there will not make a significant impact on your IVF cycle or on the sperm." Phew!

I also posted to an IVF message board, and received some encouraging responses that brought me some relief:

• "My nurse told me that I was allowed one glass of wine each night during stims, but I did not partake. I only stopped drinking the day before my first stim shot. I have also been told that 1 drink with caffeine per day is ok...I am still in my two week wait, so I don't know if my cycle worked or not yet, but I wouldn't stress too much about it. Nothing you can do to change it now unless you want to wait 3 more months before you start."
• "I drank on a regular basis leading up to stims (I'm a one drink per day kinda gal, plus several drinks per day on weekends). I did absolutely abstain during stims though."
• "We did IVF beginning of January so lots of holiday parties, New Years, both our birthdays in January etc. I got 9 blasts out of 14 eggs and am 19 weeks with a healthy little boy. You know what is worse than the beer and wine you've had... Stress. Don't worry what is done is done and many of us have had a glass or more to get thru this difficult time. You absolutely have not ruined anything!!! I would have him stop drinking by the trigger shot for the fresh sample however. Best of luck! Enjoy that glass now cause you may end up not having one for a long time if you're lucky :)"
• "I drank up until the day before starting my IVF cycle. I now have a 4 month old. Don't stress about it :)"
• "This is because it takes eggs and sperm about 3 months to develop. In the 3 months prior to IVF you are both producing the eggs and sperm that will ultimately be used to create your embryos. Technically, anything you do during this time period can have an impact on your eggs and sperm. There are lots of recommendations involving diet, alcohol, supplements and even the avoidance of BPA or other environmental toxins. It's impossible to do everything perfectly and it sounds like you've only had a moderate amount of alcohol anyway! I didn't prepare at all for my first IVF cycle. I had 1 or 2 drinks a day up until 3 weeks before retrieval. It worked for me and many people are successful with IVF without having to prepare at all. I'll be 2 years older (35) for my next IVF cycle and that scares me so I am preparing this time, including drastically reducing alcohol."

I think that it wouldn't hurt to reduce or eliminate alcohol and caffeine in the 3 months prior to IVF (for both you and your husband), but that ultimately, it is not going to drastically compromise your chances. I think that had I known this information prior to starting, I would have cut out alcohol and reduced my caffeine intake starting in March...but since I didn't know this, I'm not going to stress about it. As Plautus said, "Factum est illud; fieri infectum non potest." Done is done; it cannot be made undone.

Day 7 of Stims

Top: Gonal-f
Bottom: Cetrotide in its "Lunchables" pack

Update
I started stims on Friday (5/20/16), had a check up on Monday (5/23/16), and again yesterday (5/25/16). On Monday, during the u/s, the sonographer found 9 follicles in my right ovary and 10 in my left, and was able to measure a number of them that were 10+ mm. That afternoon, my nurse called and told me that they were surprised to see how quickly I was progressing (she assured me this was "a good problem to have") and that the doctor wanted to dial back on my Gonal-f (from 175 IU to 150 IU), to increase my Menopur (from 75 IU to 150 IU) and to add in a morning injection of Cetrotide (0.25 mg). My estrogen (estradiol) level was at 109 pg/ml. Yesterday, the u/s showed that more follicles were enlarging, and when my nurse called she said that my estrogen level was now at 781 pg/ml. My next appointment is tomorrow (Friday, 5/27/16).

Stims: Day 6 - 2nd morning of Cetrotide (25 mg),
5 nights of Gonal-f (175-150 IU) & Menopur (75-150 IU)

Starting Cetrotide
I was a little nervous to inject the Cetrotide, as I've heard it also burns and can cause an itchy rash at the injection site, but I found it to be pretty unremarkable. It is refrigerated, and comes in its own little "Lunchables" style pack, with syringe pre-filled with sterile water, powder vial, and alcohol swabs--I like how convenient this is. My only problem with it is getting all of the powdered medicine to dissolve completely. The injection itself didn't burn for me and only itched a tiny bit the first day, but nothing like a mosquito bite or anything. I did bruise at the first injection site. This morning when I did the injection, I accidentally stabbed my middle finger as the needle bent and went through the cap. I'm not sure if it was the throbbing pain in my finger or the medicine, but I got super nauseated and dizzy, and it was all I could do to rifle through my parents' bathroom drawers to find some Neosporin before I passed out. Luckily, I just barely made it to my bed before falling over. It was a rough morning.

The trigger
I got some good news from my nurse. I have been a little anxious about my upcoming trigger injection, as most of what I've read has stated that they need to be injected intramuscularly (i.e., in the butt muscle). We were prepared to hire a nurse who would be on call for 3 consecutive evenings (cost ~$125-$175) to come give me the injection, which could very well be in the middle of the night. My nurse told me that all my medications including the trigger injection will be given subcutaneously in my abdomen. She explained that there are 2 types of trigger injections: Lupron and HCG. "The reason why some physicians use one over the other is the mechanism of the trigger. For those patients who have a lot of follicles or are at risk for developing ovarian hyperstimulation syndrome (OHSS), you would use the Lupron, as this medication is in your system for a short amount of time. The HCG trigger is for the patient who will have an average response to the stimulation medication as the HCG medication is in the system longer." So I don't need to hire a nurse, and I can do the trigger injection myself!

Exercise
I was told I could continue my normal cardio and strength training during the early stages of injections (days 1-5), but by day 6, I would want to decrease the intensity and focus on non-impact exercises (yoga, light elliptical, swimming, etc.). Yesterday was day 6, so I took Noah for a 2 mile walk. Today I am going to do the same, but also hit the gym for a light elliptical workout (decreased intensity/time). I did an entire week's worth of cardio/strength from Saturday-Tuesday, so I was at least able to get that in...but it's going to kill me a little to not be able to do strength training as usual. Oh well...I'll live.

Mickey Collector's Series Band-Aids

Little treats
I've decided to reward myself after my nightly injections with a little treat: popsicles. I am loving these little Outshine Fruit Bars. They're only 35-45 calories a pop (ha!). I also got some Mickey Band-Aids, because who doesn't love Mickey? Little things like that, walking the dog, and working out, have helped keep me sane. I've been getting daily headaches which I am able to treat (for the most part) with Extra Strength Tylenol, lots of water, and naps...I've been taking lots and lots of naps!

1st and 2nd night of Stims

I did it. I gave myself 2 injections last night.

Last night I went to see my friend, Vince, play a show in WV, and then left early to get home before 10:00pm to give myself my first injections. My mom was by my side, but I insisted on doing everything myself.

Currently, I am taking 175 IU of Gonal-f and 75 IU of Menopur. Gonal-f is refrigerated, and can come in the Redi-ject pen, which is a disposable, pre-filled, and ready-to-use. You just dial your dosage, screw on the needle, and inject. Gonal-f (Gonadotropin FSH) is a follicle stimulating hormone that basically makes multiple follicles (cysts containing eggs), and causes multiple eggs to grow to a mature size. The Menopur needs to be reconstituted with sodium chloride solution (sterile water). Then you draw it up in a syringe from the vial and inject it. Menopur has 2 kinds of hormonal activity: FSH (which helps increase egg production, like Gonal-f) and LH activity (which assists with ovulation).

I did the Gonal-f first, because I knew the Menopur was going to sting. I will say that both needles were small and did not really hurt that much going in. The Gonal-f does not sting, but the pen trigger bothers me because I'm not able to watch as the medicine goes in, the way you can with a regular syringe. Mixing the Menopur is an art form, and I had to watch the instructional videos several times. It's really hard to get every drop of medicine out of those vials into the syringe. The Menopur does sting, and it seems to sting more toward the end. It's not unbearable, it's just uncomfortable. 

Left: Look how cute this little Sharps container is!
Right: The Menopur comes with vials of sodium chloride solution you use for reconstitution.

Last night, I felt good after my injections and I was really proud of myself. Today I am feeling a little depressed realizing I'll be doing this everyday (and eventually twice a day) for a couple weeks. I really cannot imagine doing multiple rounds of IVF. There is so much involved!

I think the hardest part, for me, is the isolation. This is a very lonely process, especially with my husband and friends nearly 2,200 miles away. Since we haven't told many people, I can't really post about anything on social media, which is hard. I am one of those people that really thrives on the support and encouragement received from others on social media...and since I can't really talk about my experience, I am relying on the support and encouragement of the few people that know about it...and of course, most everyone is super busy and preoccupied with their own lives, so I don't want to trouble them with my woes.

Right now I really just want to lie on my couch under my favorite blanket, snuggle my Golden Retriever, watch a cheesy Lifetime movie, and cry. Part of me wants to tell everyone, "Hey, this is what I'm doing. Look how brave I am giving myself injections every night. I'm doing this so that maybe we can have a baby. This. Really. Sucks." But I can't. 

So instead, I am trying my best to stay sane...I'm working out as much as I can within the restrictions I've been given. Under doctor's orders, I've eliminated alcohol and caffeine from my diet, and the only painkillers I can take are Extra Strength Tylenol (meaning my normal go-to for headaches, Advil, is out.) 

This is going to be a long couple of weeks...

Baseline Appointment & Starting Stims

I finished my birth control pills yesterday, so today was my baseline appointment at the clinic. They drew my blood and then did a (vaginal) ultrasound (u/s) to check the follicles in my ovaries. The doctor said that my uterine lining is thin (as expected) and although it took them awhile to find my left ovary (which was hiding), all my follicles look evenly sized, which is good.

My nurse called this afternoon and said my bloodwork (bw) and u/s results look good, so I should begin my stimulation (stim) injections on Friday. I will start with 2 injections in the evening only (Gonal-f and Menopur) and then they will do more bw and another u/s on Monday, and then again on Wednesday. 

I am super nervous about giving myself the injections. My parents have offered to do them for me, and my mom also has a friend (former nurse) who has offered to help, but I feel like I need to suck it up and learn how to do it myself (at least the subcutaneous injections). Even though I'm only doing them once in the evening now, I may eventually need to do them twice a day, and it's likely I will have to give them to myself at some point. I've read that the Menopur stings, so I'm apprehensive about that. I had to give subcutaneous injections to my dog before, so hopefully I can learn to do it to myself too.

I asked the doctor and nurse if I can continue working out, and they both said that moderate exercise should be okay. Hopefully that will help keep me busy and my mind from worrying!

Trolls

I saw this IVF baby announcement in the headlines yesterday. I read the article because it is relevant to me, gasped at the number of injections (since I begin stims Friday), and then made the mistake of reading some of the comments.

The majority of the commentary is supportive and positive, but there are a few comments that are extremely ignorant and downright mean. I mean, it's the Internet after all; what do I expect?

I thought I'd post some of those comments here, post some of the meaningful responses to them, and address some of them myself. 



"Maybe you just aren't meant to have kids..."

There seems to be many comments like this one pointing out that this woman "wasn't meant to have kids" because her body was obviously telling her not to. This frustrates me because people often assume that infertility is always a woman's issue--it's not. "Infertility is often believed to be a woman's problem. However, studies indicate that 30% of infertility is related to male factor problems such as structural abnormalities, sperm production disorders, ejaculatory disturbances and immunologic disorders" (RESOLVE, 2016). This hits particularly close to home given our particular situation. I particularly like Galyna's response to Marcus.

"If you have the money to do IVF, why don't you adopt?"

This is another common one. My response is that not everyone is called to adopt. Adoption, just like IVF, isn't for everyone...so why do people who can afford IVF (and are considering it) have to be the only ones to consider adoption? There are plenty of "privileged" fertile people out there that "should" consider it too. Many argue that adoption is "free" or "cheaper" than IVF through the foster care system, but why doesn't that pressure fall on everyone else too, not just people who choose to try IVF? There are also many that are able to afford IVF because of their insurance, but may no be able to afford adoption.

Not all adoptions are free. According to American Adoptions, the average total cost of adopting through a domestic adoption agency is $39,966 (including agency fees, legal fees, birth mother expenses, and advertising/networking). International adoption averaged $36,338 in China, $45,960 in Ethiopia, and $40,067 in Ukraine from 2012-2013. Going through your state's foster care system is "the least expensive method" but again, "foster care adoption is not for everyone and presents it's share of challenges to adoptive families." There are also home study fees, attorney fees, and travel expenses involved. 

Adoption itself can be a controversial topic with people criticizing those who choose to adopt internationally vs. domestically, or those who prefer to go through a private agency vs. their state's foster care system. Again, I think people can be overly critical and judgmental. I think most couples think long and hard about what they feel led to do, and what they feel is best for their family and given situation. My husband actually has 2 adopted siblings, we have many friends who are adopted, and we know many that have adopted or are in the process of adopting. I think this is great. I also don't think we would never consider adopting, but we have decided we want to try IVF at this point in time. This is our choice and our decision. 

I've also heard many stories where foster care and adoption ended in devastating heartbreak. There may be so much more to why a couple has chosen to try IVF instead of adoption, and vice versa. The thing is, you don't know their particular situation, so don't make hasty judgments! Some friends of ours have been going through the international adoption process for 3 years, and it will probably be another year before they are able to bring their child home. This has been a long and frustrating experience for them.

I love some of these responses:

"This cant be healthy..."

This is a legitimate concern. There are many drugs and hormones involved with the IVF procedure, as well as many of the other non-IVF fertility procedures. Calling IVF "Frankensteinish" is a little brash, but I can understand why. People wonder how IVF affects the mother as well as the baby. I think that most couples going through IVF do a lot of thinking and research, and seriously weigh the risks and benefits before jumping in. The truth is that 1978 (the first IVF pregnancy) is not that long ago, and more research remains to be done. I will say that I know several people who have healthy, intelligent children as a result of IVF. In fact, one of my students this year was an IVF baby, and she was at the top of the class. I also know that there may be future health risks involved. However, again, I weighed the risks and benefits just like I do when I take any new medication or vaccine, and I decided that the benefits outweighed the risks in our case.

 "Congrats!"

The majority of the comments were positive and encouraging. It's nice to see people be happy for and kind towards others. 

I will admit I was a little hurt when I read some of the negative comments posted on the Yahoo! version of this story, and I made the mistake of reading some of the corresponding FB and Today.com comments, but my mom made me feel better about the situation. She reminded me of the many Internet trolls that have nothing better to do than to post controversial comments to get others riled up. She also reminded me that my decision to try IVF was between me, my husband, and God, and that it was no one else's business but ours.

We still haven't told anyone beyond our parents and a few close friends about our choice to try IVF. I honestly don't know what people will say, how they will react, or if they will support our decision. I admit I'm a bit nervous about it...but right now I am focusing on the task ahead--mainly, starting my stims injections in a few days--and we will cross that bridge when the time comes. 

My point in writing this post is to encourage you to not to let others get you down. Remember that some people are naive, some people are ignorant, and some people are just downright mean...but the majority of people are kind, encouraging, and supportive. Focus on the comments and well wishes of those people, and don't let the trolls and ugly hearts get you down!